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Wednesday, October 30, 2013

Dear Respiratory friends we are happy to present new Smoking Cessation Guidelines!

The European Smoking Cessation Guidelines and Quality Standards
are the main output of a project undertaken by ENSP to create a
coherent and reliable set of guidelines for healthcare professionals
working in the field of smoking cessation. The Guidelines form a
complete range of tools to support smoking cessation strategies. The
work was undertaken by the Editorial Board comprising seven eminent
professors and the Board of Revisers from across the entire European
continent and is the first of its kind. These guidelines are in
accordance with Article 14 of the Framework Convention on Tobacco
Control (FCTC), which states that:

Parties
should develop and disseminate comprehensive tobacco dependence
treatment guidelines based on the best available scientific evidence and
best practices, taking into account national circumstances and
priorities. These guidelines should include two major components: (1) a
national cessation strategy, to promote tobacco cessation and provide
tobacco dependence treatment, aimed principally at those responsible for
funding and implementing policies and programs; and (2) national
treatment guidelines aimed principally at those who will develop, manage
and provide cessation support to tobacco users.

This project aims to support smoking cessation activities and strengthen their impact by:

providing health professionals with a European template of smoking cessation guidelines and best practice;

providing the tobacco control community with tools for monitoring and accreditation.

Tuesday, October 29, 2013

Dear Respiratory friends we are re-posting interesting questions and answers from American College of Chest Physicians and American Thoracic Society!

1

Don’t
perform computed tomography (CT) surveillance for evaluation of
indeterminate pulmonary nodules at more frequent intervals or for a
longer period of time than recommended by established guidelines.

Clinical
practice guidelines for pulmonary nodule evaluation (such as those
issued by the Fleischner Society or the American College of Chest
Physicians) suggest that intensity of surveillance should be guided by
the likelihood of malignancy. In patients with no prior history of
cancer, solid nodules that have not grown over a 2-year period have an
extremely low risk of malignancy (although longer follow-up is suggested
for ground-glass nodules). Similarly, intensive surveillance (e.g.,
repeating CT scans every 3 months for 2 years or more) has not been
shown to improve outcomes such as lung cancer mortality. Meanwhile,
extended or intensive surveillance exposes patients to increased
radiation and prolonged uncertainty.

Evidence
and clinical practice guidelines have not established benefits of
vasoactive agents (e.g., prostanoids, phosphodiesterase inhibitors,
endothelin antagonists) for patients with pulmonary hypertension
resulting from left heart disease or hypoxemic lung diseases. Moreover,
the use of these agents may cause harm in certain situations and incurs
substantial cost and resource utilization. Patients should be carefully
assessed (including at a minimum right heart catheterization,
echocardiography, chest CT, six minute walk test and pulmonary function
testing) to confirm that they have symptomatic pulmonary arterial
hypertension prior to having approved agents initiated.

3

For
patients recently discharged on supplemental home oxygen following
hospitalization for an acute illness, don’t renew the prescription
without assessing the patient for ongoing hypoxemia.

Hypoxemia
often resolves after recovery from an acute illness, and continued
prescription of supplemental oxygen therapy incurs unnecessary cost and
resource use. At the time that supplemental oxygen is initially
prescribed, a plan should be established to re-assess the patient no
later than 90 days after discharge. Medicare and evidence-based criteria
should be followed to determine whether the patient meets criteria for
supplemental oxygen.

Clinical
practice guidelines for pulmonary embolism indicate that the cost and
potential harms of CT angiography (including radiation exposure and the
possibility of detecting and treating clinically insignificant pulmonary
emboli with anticoagulation) outweigh the benefits for patients with a
low pre-test probability of pulmonary embolism. In patients with a low
clinical prediction score (e.g., Wells or Geneva score) followed by a
negative D-dimer measured with a high sensitivity test (e.g., ELISA),
pulmonary embolism is effectively excluded and no further imaging is
indicated for pulmonary embolism evaluation.

Low
dose chest CT screening for lung cancer has the potential to reduce
lung cancer death in patients at high risk (i.e., individuals aged 55-74
with at least a 30-pack year history of tobacco use, who are either
still smoking or quit within the past 15 years). However, CT screening
for lung cancer also has the potential to cause a number of adverse
effects (e.g., radiation exposure, high false positive rate, harms
related to downstream evaluation of pulmonary nodules, overdiagnosis of
indolent tumors). Thus, screening should be reserved for patients at
high risk of lung cancer and should not be offered to individuals at low
risk of lung cancer.

Sunday, October 27, 2013

We
are happy to invite you in 2014 at Firenze, Italy for Master Studies in
Interventional Pneumology, which is organized by great friend of
Respiratory Decade Professor Lorenzo CORBETTA.Please find links with program of Master Studies!

Many medical students and young people are asking me about effects of waterpipe tobacco smoking or narghila. it is so dangerous as smoking or no?

Waterpipe tobacco smoking is a centuries-old tobacco use method with an ambiguous origin
and links to the countries of southwest Asia and north Africa. Although
known by many different names (eg, hookah, narghile, shisha), the term waterpipe has been used for the last 2 decades in the English language scientific literature
to refer to any of a variety of instruments that involve passing
tobacco smoke through water before inhalation. Contrary to popular
belief that waterpipe tobacco smoking is less lethal than cigarette
smoking, emerging research indicates that both involve comparable health risks including nicotine/tobacco dependence.

Friday, October 25, 2013

New study on COPD Surveillance in United States, 1999-2011 was published in Chest!!

COPD
is a serious public health problem in the United States. In 2008,
chronic lower respiratory diseases, of which COPD represents the
principal component, became the third leading cause of mortality. Because smoking is the dominant risk factor for COPD and contributed to about 80% of COPD deaths in 2000 to 2004, much of this disease is potentially preventable. People with COPD
experience worse health-related quality of life, more disabilities, and
higher rates of comorbidities than people without COPD.

This
report updates surveillance results for COPD in the United States. For
1999 to 2011, data from national data systems for adults aged ≥ 25 years
were analyzed. In 2011, 6.5% of adults (approximately 13.7 million)
reported having been diagnosed with COPD.

It can be a Revolution in treatment of Multidrug-Resistant Tuberculosis!

Multidrug-resistant tuberculosis (MDR TB) is caused by Mycobacterium tuberculosis
that is resistant to at least isoniazid and rifampin, the two most
effective of the four first-line TB drugs (the other two drugs being
ethambutol and pyrazinamide). MDR TB includes the subcategory of
extensively drug-resistant TB (XDR TB), which is MDR TB with additional
resistance to any fluoroquinolone and to at least one of three
injectable anti-TB drugs (i.e., kanamycin, capreomycin, or amikacin).
MDR TB is difficult to cure, requiring 18–24 months of treatment after
sputum culture conversion with a regimen that consists of four to six
medications with toxic side effects, and carries a mortality risk
greater than that of drug-susceptible TB.

Bedaquiline fumarate (Sirturo or bedaquiline) is an oral
diarylquinoline. On December 28, 2012, on the basis of data from two
Phase IIb trials (i.e., well-controlled trials to evaluate the efficacy
and safety of drugs in patients with a disease or condition to be
treated, diagnosed, or prevented), the Food and Drug Administration
(FDA) approved use of bedaquiline under the provisions of the
accelerated approval regulations for "serious or life-threatening
illnesses" (21CFR314.500) (Cox EM. FDA accelerated approval letter to
Janssen Research and Development.

Wednesday, October 23, 2013

Dear Respiratory Friends now you can sign European Parliament Written Declaration on Recognizing the Burden of Allergic Disease!

Allergic diseases affect over 150 million Europeans, of whom some are affected by severe, debilitating diseases, but these are neglected as a public health concern. Members
of the European Parliament now have an opportunity to call on
the European Commission and EU Member States to take action by signing a
Written Declaration on Recognising the Burden of Allergic Disease, which opened for signatures in October 21st and will remain open until January 21, 2014.

1. More than 150 million EU citizens suffer from chronic allergic diseases, half of whom are undiagnosed due to a lack of awareness and shortage of medical specialists;

2. More than 100 million Europeans suffer from allergic rhinitis and 70 million from asthma,the most common non-communicable diseases in children and the main cause of children’s emergency room visits and hospital admissions;

3. More than 17 million Europeans suffer from food allergies or severe allergies implying a risk of acute attacks or anaphylaxis with life-threatening potential;

4. Allergies are an underestimated cause of unhealthy ageing and have a severe impact on social, professional and educational performance, especially in children, causing socioeconomic inequalities;

5. The Commission is therefore called upon to encourage cooperation and coordinationbetween Member States to promote: national allergyprogrammes to reduce the disease burden and health inequalities; training in allergies and multidisciplinary care plans to

improve disease management; use of preventive and tolerance-inducing approaches toallergy treatment; and scientific research into direct and indirect allergy risk factors,including pollution;

6. This declaration, together with the names of the signatories, is forwarded to the Commission.

Friday, October 18, 2013

A fresh guideline on pulmonary rehabilitation has been published this
week, helping professionals, patients and the public understand what to
expect from a pulmonary rehabilitation programme.

The new guideline, produced by the European Respiratory Society and the American Thoracic Society, supports the use of pulmonary
rehabilitation as an essential part of the care offered to people with
chronic obstructive pulmonary disease and other long-term lung
conditions.

Saturday, October 12, 2013

Dear friends we are reproducing and supporting Letter to President of European Parliament about Philip Morris lobbying activities on the Tobacco Products Directive

Dear President Schulz,

We are writing to express our very deep concerns regarding the attempts by the tobacco industry lobby to derail vital public health legislation currently going through the Parliament.

As you will know, the EU is currently finalising the review of Tobacco Products Directive (TPD), a crucial piece of legislation
for protecting the public from tobacco (the largest preventable cause
of death and disease in the world). However, in recent weeks, European
news media such as The Guardian, Der Spiegel and Le Parisien have reported extensively about leaked documents which outline the lobbying strategies and activities of tobacco giant Philip Morris International to influence the European Parliament’s decision-making on the TPD. There is widespread concern that the decision to delay
the plenary vote on the TPD was a result of tobacco companies like
Philip Morris International and others using their economic and
political power to influence MEPs. The postponement of the vote is
widely believed to be part of a tobacco industry strategy to delay,
weaken or even derail the TPD. The leaked documents show that no less than 233 MEPs (almost one third of the Parliament) have been met by Philip Morris International lobbyists at least once. Several MEPs were listed as having had four or five such meetings.

This large number of meetings (which have taken place behind closed
doors, without any transparency such as the publication of minutes from
these meetings), constitutes a serious violation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) Article 5.3 which is geared towards safeguarding public health policy-making from tobacco industry interference. FCTC Article 5.3 recognizes the fundamental and irreconcilable conflict of interest
between the tobacco industry and public health policy-making. It also
recognises that the tobacco industry has, for decades, been working
tirelessly to delay, block, and weaken life-saving health measures, like
those enshrined in the FCTC.

FCTC Article 5.3 requires all Parties, when deciding on their public health policies with respect to tobacco control to
“. . . act to protect these policies from commercial and other
vested interests of the tobacco industry in accordance with national
law”.

The WHO’s accompanying guidelines stipulate that decision-makers “should
interact with the tobacco industry only when and to the extent strictly
necessary to enable them to effectively regulate the tobacco industry
and tobacco products.”

The guidelines state that
“where interactions with the tobacco industry are necessary, Parties
should ensure that such interactions are conducted transparently”.

We are deeply concerned about the astounding level of access to MEPs by tobacco lobbyists
which has been exposed in the leaked Philip Morris International
documents. As President of the European Parliament, we consider that it
is your urgent responsibility to take determined action to ensure proper implementation of Article 5.3 of the FCTC,
in order to assure that the Parliament protects its decision-making
from tobacco lobby influence. This is crucial in order to protect public
health and the interests of EU citizens in strong tobacco regulation
and for the Parliament to fulfill its UN obligations.

Monday, October 7, 2013

Three researchers who studied how cells shuttle around essential
molecules in tiny intracellular sacs have won this year’s Nobel Prize in
physiology or medicine. James Rothman of Yale University; Randy
Schekman of the University of California, Berkeley; and Thomas Südhof of
Stanford University earned the award
"for their discoveries of machinery regulating vesicle traffic, a major
transport system in our cells," according to the announcement from the
Nobel Assembly at Karolinska Institute in Stockholm.

The three researchers independently unraveled basic cellular
mechanisms several decades ago—in Schekman's case, almost 40 years ago.
Although mistakes in cellular transport systems can cause a variety of
diseases—including diabetes and neurological and immunological
disorders—their work has not yet led to any new drugs or therapies, but
it has helped others develop diagnostic tests.

Saturday, October 5, 2013

Over the past century we have become adept at suppressing the symptoms
of respiratory diseases but we have made little progress in curing them.
Respiratory diseases are responsible for over 650,000 deaths annually
in the EU and the burden on health systems is increasing as the
population ages. A revolutionary collaborative approach to research
funding is providing new insights into the origins of chronic
respiratory diseases. All stakeholders in respiratory medicine are
pooling their knowledge and resources to focus on risk factors to find
cures, formulate new vaccines and develop cutting-edge technologies to
tackle the burden of chronic respiratory diseases.

Friday, October 4, 2013

The American Sleep Medicine Foundation selected an effects-heavy YouTube
video about the benefits of sleep as the grand-prize winner of the
first-ever ASMF Sleep Story Video Contest. The video was created by
Jasper Lown, a senior at Wheaton-Warrenville South High School, located
near Chicago. His two-minute video uses creative visuals to provide
simple tips to improve sleep habits. His sponsoring teacher was Tim
Brylka.

Tuesday, October 1, 2013

To address the global phenomenon of disparities in respiratory health,
the American Thoracic Society and the European Respiratory Society have
released an official policy statement in which each pledges its
commitment to reducing health disparities between the lowest and highest
socioeconomic groups by continuing or initiating work with leaders from
governments, academia, and other organizations to promote scientific
inquiry and training, disseminate medical information and best
practices, and monitor and advocate for public respiratory health.

Klaus Rabe, MD, writing committee member and a past president of ERS,
continued: "The effects of health disparities in Europe on respiratory
disease are very pronounced. Individuals in lower social groups are not
only more likely to have respiratory diseases, but, compared with other
disorders, social inequality is associated with a larger proportion of
deaths from these diseases."

The American Thoracic Society and European Respiratory Society pledge to frame their actions to reduce respiratory health disparities. The vision of the ATS and ERS is that all persons attain better and sustained respiratory health. They call on all their members and other societies to join in this commitment.

Read COPD Research and Practice

COPD Research and Practice publishes basic and clinical research and review articles relating to the development, progression and treatment of COPD and related disorders

Read Current Respiratory Medicine Reviews

Current Respiratory Medicine Reviews publishes original research papers, frontier reviews, drug clinical trial studies and guest edited issues dedicated to clinical research on all the latest advances on respiratory diseases